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True Story: Man Dies From Following Alternative Medical Advice On The Internet

Photo Credit: Mark Crislip, M.D.

During a recent trip, I met a woman whose father had just passed away. When she discovered that I was a physician, she decided to tell me the sad story of the events leading up to his death. She gave me permission to share the story on my blog so long as I did not identify her or her family by name. For the purposes of the story, I’ll refer to the woman as Sue, and her father as Frank.

Frank was a healthy, robust man, descended from a long line of nonagenerians. Everyone assumed that he would live well into his 90′s – at least 30 more good years. One day Frank began having some leg pain, which he ignored as long as he could. Sue noticed him limping around a week later and decided to take him to see a physician. As it turned out, Frank had a deep venous thrombosis (or blood clot) in his leg, caused by a previously undiagnosed, mild genetic clotting disorder. The physicians treated him with heparin to prevent the clot from expanding, and prescribed coumadin to protect him from having the clot travel to his lungs – a condition (pulmonary embolism) that carries with it a high risk of death.

While researching his new medicines, Frank came upon an alternative medicine website. The site warned people against taking coumadin (stating that it was “a form of rat poison”) and offering herbal supplements instead. Frank decided to stop taking his coumadin, and purchased the alternative medicine from the website. Two weeks later he Read more »

Skeptic Uncovers Some Of The Week’s Medical Quackery

Hey there skeptifans. Here are the media Fails and Wins you sent me last week.

Edzard Ernst on alternative medicine
After Steve Jobs death, which we now know may have been hurried due to his decision to choose alternative treatments over evidence based ones, Maclean’s chose to run this Q&A with alternative medicine expert Edzard Ernst. Several years ago Dr. Ernst set out to find out if there is evidence to support the most popular alternative treatments. His findings were that the vast majority of alternative medicine is quackery. I hope this interview will help sway some people on the fence about chiropractic and other placebo treatments.

Family Doc Says No To Perilous Chickenpox Pops
Anna spotted this story on NPR. Apparently, there is a mom in Texas selling chicken pox infected lollipops to Read more »

*This blog post was originally published at Skeptic North*

Research Looks At Chewing Gum Flavoring For Infection Prevention

Gumballs by Patrick Hoesly via Flickr and a Creative Commons license

A common flavoring of chewing gum was associated with a 25% reduction in acute otitis media (AOM) in a small meta-analysis of children in Finnish day care centers, researchers reported.

Chewing gum has long been touted by gum manufacturers for preventing tooth decay and by frequent flyers for keeping one’s ears from popping during take-offs and landings. It’s been looked at for heartburn from overeating, relief of stress and anxiety and in dieting (although sugar-free gum has no more effect, it’s been recently noted).

Now, one of gum’s common flavorings, xylitol (birch sugar) is being looked at for its antibitoic properties in an age of antibiotic overuse and potential drug resistence. Xylitol has been used for decades as a natural non-sugar sweetener in gum, toothpaste and medicines.

AOM is the most common bacterial infection among young children in the United States. By the age of one, approximately Read more »

*This blog post was originally published at ACP Internist*

The Mind’s Tremendous Influence Over The Body

24 years old female presents with several week history of progressive stomach pains, substernal chest discomfort, heart palpitations, loss of appetite, headache, insomnia, and growing lump sensation in her throat. Physical exam was essentially normal.

Can this previously healthy female have suddenly developed reflux, globus, paroxysmal supraventricular tachycardia, brain tumor, and throat cancer with possible overlying thyroid disorder? Or perhaps has she contracted some other horrific mystery disease?

Maybe…

But maybe none of the above…

What if I told you she will be giving a doctoral dissertation for her Master’s next week for which she is ill-prepared given a recent breakup with her boyfriend of 5 years and a growing distaste of her school classmates who have been less than supportive.

In other words, Read more »

*This blog post was originally published at Fauquier ENT Blog*

Health And Wellness Programs: When Faith Overtakes Reason

There’s a new term that has entered the medical lexicon. The word is wellness. Hospitals and medical offices are incorporating this term into their mission statements, corporate names, business cards, medical conferences and other marketing materials. The Cleveland Clinic Foundation has appointed a Chief Wellness Officer, an intriguing fluffy title that does not clearly denote this individual’s role and function. This is deliberate, as the word wellness is designed to communicate a ‘feel good’ emotion, not a specific medical service.

Just a click or two on Google will lead you into the wellness universe. Here’s a sampling:

  • Institute of Sleep and Wellness
  • Wellness Institute of America
  • Naturopathic Wellness
  • National Wellness Institute
  • Physicians Health and Wellness Center
  • Physicians Wellness Group

There’s even a sponsored ad on Google where one can Read more »

*This blog post was originally published at MD Whistleblower*

Latest Interviews

How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

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Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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Latest Cartoon

Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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Click here for a musical take on over-testing.

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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